[Intrathoracic dislocation fracture of the head of the humerus].

We present a rare case of fracture-dislocation of shoulder with intrathoracic displacement of the humeral head. This case is well documented by CT. The mechanism and treatment modalities are discussed, and pertinent literature is reviewed.

Interleukin (IL)-6 and its soluble receptor induce TIMP-1 expression in synoviocytes and chondrocytes, and block IL-1-induced collagenolytic activity.

To define the potential role of interleukin-6 (IL-6) and its soluble receptor alpha in cartilage metabolism, we analyzed their effects on tissue inhibitor of metalloproteases (TIMP) synthesis by synoviocytes and chondrocytes. TIMP-1 production by isolated human articular synovial fibroblasts and chondrocytes, stimulated by IL-6 and/or its soluble receptor, was first assayed by specific enzyme-linked immunosorbent assay; the slight stimulatory effect of IL-6 on TIMP-1 production by both types of cells was markedly amplified by the addition of soluble receptor, the maximal secretion being observed only at 96 h. TIMP-1 mRNA expression, determined by ribonuclease protection assay, was induced by IL-6 together with its soluble receptor, but TIMP-2 and -3 mRNAs were not affected by these factors.

[Distal humeral fracture in adults: functional evaluation and measurement of isometric strength].

Purpose: The purpose of the study was to determine prognostic parameters in adult distal humeral fracture.

Material: Thirty patients were reviewed retrospectively at a mean follow-up of 5 years. According to the AO classification there were 5 type A, 5 type B and 20 type C fractures, of which 7 were open.

Restoration of metacarpophalangeal extension of the thumb in inflammatory arthritis.

Nine patients (11 cases) with inflammatory arthritis who had an early boutonnière deformity of the thumb treated by rerouting of the extensor pollicis longus tendon were reviewed. Preoperatively, all patients complained of pain, disability in activities of daily living and extensor lag of the MP joint ranging from 10 to 60 degrees. At a mean follow-up of 38 months, nine thumbs had equal active and passive MP joint extension.

Fasciculated intramedullary pinning of metacarpal fractures.

We reviewed 20 patients with 23 displaced extraarticular fractures of the distal end of the long metacarpals, treated by fasciculated pinning. At a mean follow-up of 5 years, all the patients were subjectively satisfied with the result. All the patients but one, who fractured four metacarpals, had a normal range of motion.